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Swanson’s Five Drops.

If one is searching for a perfect example of why the Pure Food and Drug Act of 1906 was needed, this 1901 SWANSON'S RHEUMATIC CURE CO. foldover brochure would fit the bill (Figures 1A, 1B, and 1C). The SWANSON "FIVE DROP" REMEDIES were heralded as "the faithful guardian and sentinel of the human system" that "stands at the door and challenges every germ that knocks for admittance." FIVE DROPS had an "unfailing effect in the following diseases Rheumatism in all its forms, Sciatica, Backache, Neuralgia, Nervousness, Sleeplessness, Nervous and Neuralgic Headaches, Nervous Dyspepsia, and Nervous affections of every description, Asthma, Hay Fever, Croup and Bronchitis, Catarrh, Heart Weakness, (), Earache, La Grippe, Malaria, Creeping Numbness and kindred diseases." What couldn't these drops cure? A bottle of Swanson's Five Drops is pictured in Figures 2A and 2B.

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Cannabidiol (CBD) as a treatment of acute and chronic back pain: A case series and literature review.

Two patient case reports are presented describing the use of cannabidiol (CBD) for the symptomatic relief of a lumbar compression fracture and in the mitigation of thoracic discomfort and dysesthesia secondary to a surgically resected meningioma.

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Ketamine for Migraine in the Emergency Department.

Ketamine is utilized often in the emergency department (ED) for rapid sequence intubation, procedural sedation, and acute pain management. The treatment of migraine headache in the ED varies widely and is dependent on several factors including migraine cause, previous successful abortive methods, and provider preference. Several medications are currently employed to treat acute migraine including nonsteroidal anti-inflammatory drugs, triptans, antihistamines, prochlorperazine, and corticosteroids, among others. Interest in ketamine as an abortive agent to treat migraine has increased as evidenced by recent studies evaluating its use in the ED. This review examines the data regarding the use of ketamine to treat migraine headache. The concept of treating migraine headache with ketamine has been studied for more than 20 years. Early studies conducted primarily in the outpatient setting evaluated ketamine through multiple routes of administration and differing migraine causes with varying results. These early data seem to suggest that ketamine provides relief from headache severity but provides little information regarding the optimal dose and route of administration. Recent active comparator and placebo-controlled trials in the ED utilizing subdissociative doses of ketamine (0.2-0.3 mg/kg intravenously) show conflicting results. To confound the decision regarding its use further, ED providers encounter differing recommendations regarding its place in therapy. Current data suggest that ketamine may provide pain relief to patients with migraine headache. Although there may be a role for ketamine in certain cases after more robust evidence becomes available, currently it is premature to incorporate ketamine into routine use. Several questions remain to be answered including its overall efficacy, place in therapy, dosage, and risk of undesirable side effects.

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Greater occipital nerve blocks for the treatment of postdural puncture headache after labor epidural.

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A randomized control trial to compare thoracic epidural with intercostal block plus intravenous morphine infusion for postoperative analgesia in patients undergoing elective thoracotomy.

The objective of the study is to compare the efficacy of Thoracic epidural with Intercostal block plus intravenous morphine infusion for postoperative analgesia in patients undergoing elective thoracotomy.

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Cannabinoids as an Alternative Option for Conventional Analgesics in Cancer Pain Management: A Pharmacogenomics Perspective.

The global cancer burden is significantly increasing at an alarming rate affecting patients, relatives, communities, and health-care system. Cancer patients require adequate pain relief and palliative care throughout the life course, especially in terminal illness. Although opioid treatment is successful in majority of patients, around 40% do not achieve enough analgesia or are prone to serious side effects and toxicity. The treatment of medical conditions with cannabis and cannabinoid compounds is constantly expanding. This review organizes the current knowledge in the context of SNPs associated with opioids and nonopioids and its clinical consequences in pain management and pharmacogenetic targets of cannabinoids, for use in clinical practice.

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Pseudotumor Cerebri Presenting by Neck Rigidity and Torticollis.

Pseudotumor cerebri syndrome (PTCS) is an uncommon disease in children. On-time diagnosis and treatment can prevent irreversible visual loss. Although headache is the most common complaint of children with this syndrome, the present case report reported a child with neck rigidity and torticollis, declined by the reduction of intracranial pressure. Despite the importance of torticollis and neck rigidity presented in various significant neurological disorders in need of thorough investigations, in the case of unexplained symptoms of those disorders, it is recommended to consider fundoscopic examinations for PTCS to prevent its vital complications.

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Pain Beliefs and Perceptions and Their Relationship with Coping Strategies, Stress, Anxiety, and Depression in Patients with Cancer.

The current study was conducted aiming at the investigation of pain beliefs and perceptions and their relationship with coping strategies, stress, anxiety, and depression in patients with cancer.

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Bilateral erector spinae plane blocks using a small volume of local anesthetic for acute pain control after single-port laparoscopic surgery.

In the era of enhanced recovery after surgery, clinicians are encouraged to develop optimized programs for patients who require surgery. Minimal intervention with laparoscopic surgery and multimodal pain management mostly with peripheral nerve block are key components. We are developing a departmental program for enhanced recovery after surgery for single-port laparoscopic surgery. We applied an erector spinae plane block, a novel, newly recognized block, bilaterally at the T10 transverse process with a small dose (10 mL) of local anesthetic. This method was effective and safe and resulted in successful analgesia in a patient who received single-port surgery. This surgery requires a 3-5 cm horizontal or longitudinal periumbilical incision, which was performed in this case, and our results were promising and encouraging.

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Acute Rhinosinusitis as an Infrequent Cause of Symptomatic Cluster Headache: Report of Seven Cases.

Cluster headache (CH) is a primary headache disorder characterized by unilateral headache attacks lasting 15 to 180 minutes, occurring between two and eight times a day, and accompanied by autonomic symptoms ipsilateral to the pain. However, cases of symptomatic CH that occur secondary to an underlying structural pathology have also been reported in the literature. In this report, seven patients are presented who were admitted with signs of CH and diagnosed with acute rhinosinusitis depending on extensive clinical and radiologic examinations. Symptomatic CH, though rarely reported in the literature compared to CH, should be kept in mind in patients presenting with the first attack of CH. Moreover, in such patients, whether the pain becomes worse when bending forward and becomes sensitive on palpation should be questioned, and a radiologic work-up should be performed to rule out secondary causes such as rhinosinusitis. In the present cases, the resolution of CH attacks with acute sinusitis therapy confirmed the diagnosis.

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